Is there any link between periodontitis and inflammatory bowel diseases?

DESIGN

This was an analytical 'case-control' study.

CASE/CONTROL SELECTION: Patients diagnosed with inflammatory bowel diseases (IBD), that is either ulcerative colitis or Crohn's disease, were selected from the Medical Hospital of University of Turin and were referred as cases. Equal number of patients, not having IBD, were selected from the Dental school of the same University and called as controls. The cases and controls were matched for age, sex, and ethnicity. Data for all patients regarding their socio-demographic features was collected using a questionnaire. In addition, data regarding periodontal health, which included clinical attachment loss, bleeding on probing, recession, presence, and severity of periodontitis etc. was also evaluated for all the included patients.

DATA ANALYSIS: Data analysis involved descriptive statistics to compare cases and control. This was done by comparing the proportions (using χ2 test), comparing continuous measures (using median values). In addition, two logistic regression models were created to explore the impact/association of different variables with the causation of the disease; one model explored the variables associated with periodontitis while the second model explored the variables which can be risk indicators for IBD.

RESULTS

Non-significant differences were observed on comparing various socio-demographic features while significant differences were observed in the prevalence of severe periodontitis (85.6% vs. 65.6%) amongst cases and controls. Fragmenting the periodontitis-prevalence data as per age, patients in age groups 36-50 and 51-65 exhibited significant differences on comparing cases and controls, with p values of 0.002 and 0.022, respectively, while comparison of periodontitis prevalence amongst cases/controls in 18-35 age group or >65 age group non-significant differences were observed. The logistic regression models revealed strong associations between IBD and periodontitis and vice versa. Role of other risk factors was also explored in these regression models.

CONCLUSIONS

Associations between periodontitis and IBD were found; and these connotations were bi-directional.